Herniated disks, like the one Chiefs’ Dontari Poe has, can be tough for linemen

Kansas City Chiefs nose tackle Dontari Poe (center) shouted in celebration after sacking San Francisco 49ers quarterback Colin Kaepernick during a game last season. At left is Kansas City Chiefs outside linebacker Tamba Hali.
David Eulitt
deulitt@kcstar.com

ST. JOSEPH

The first thing Mike DeVito did when he heard about Dontari Poe’s recent back surgery was reach out to the 6-foot-3, 346-pounder. DeVito figured Poe, the Chiefs’ run-game anchor, could use some positivity.

DeVito, a nine-year NFL veteran, knows what it’s like to go down with a significant injury. He essentially missed all of last season with a torn Achilles, and has not been shy about sharing how hard it is to involuntarily be on the shelf.

“I texted him once I found out,” DeVito said. “He’s in great spirits and I know Poe will be back better than ever.”

Chiefs coach Andy Reid shared a similar brand of positivity on Tuesday, when he and head trainer Rick Burkholder first revealed Poe’s injury, a herniated disk that was discovered in early July.

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“I think he stands a reasonable chance (of returning) in the early part of the season,” Reid said.

That appears to be a possibility, though that remains up in the air. After Poe’s surgery (on July 15), Poe spent the last few weeks resting in Memphis before reporting to Chiefs camp.

However, Burkholder made it clear that Poe will miss the entirety of training camp, which runs through Aug. 20, as he rehabs the injury.

From there, it’s difficult to pinpoint exactly when Poe will return, according to Neel Anand, orthopedic surgeon and director of spine trauma at Cedars-Sinai Spine Center in Los Angeles.

“Recovery varies from person to person, even in athletes,” Anand wrote in an email. “But in general, if all went well with the surgery, he should able to resume training and activities within six weeks and could return to a 100% playing ability.

Anand said Poe’s rehab will consist of “intense core strengthening” and “task-specific muscle training” over the next six weeks to three months.

David Chao, who spent 17 years as a former NFL team physician, agreed with Anand’s timeline.

“My guess is, the first month (of rehab) — and I haven’t examined him — is more about pain (control), swelling and edema control and trying to maintain a little bit of baseline fitness,” Chao said. “And the next month is more transitioning into some good, hard rehab. And perhaps the last month, the third month, is (working on) football muscles, football shape, field work.”

That said, if Poe does end up following that three-month timeline, which would put him in the mix to return in mid-October, it would not be a surprise if he started the season on the physically unable to perform list.

“I don’t know him, maybe he’s Superman — and by some reports, I think he’s a pretty special guy,” Chao said. “But if he makes it week one, he should be celebrated for doing a great job.”

Chao said herniated disks are harder on linemen for a couple reasons.

“First, they’re just bigger and they’re carrying a lot more weight, and just because a guy is 350 pounds doesn’t mean the structure of his spine is twice as big as that of a 175-pound guy,” he said. “And second, it’s about core strength. In his case, two guys or more are pushing on you, and it’s hard on your lower back.”

That makes this one of the hardest positions to come back from, Chao said, because of the constant stress placed on the area.

Still, he and Anand agree that it’s generally unwise to put limitations on athletes, who are built differently than your average Joe.

“Theoretically, by having had a herniated disk, his disk will never be ‘normal’ and he could have back problems,” Anand wrote, “but most patients and especially athletes have an immense capacity to overcome adversity and work through it and function at normal ability.”

Herniated disks, Chao said, are incredibly common among linemen.

“If you gave MRIs to all the defensive and offensive linemen, more would have herniated disks of some sort than normal disks,” Chao said.

The problem comes, he said, when those disks put pressure on the spinal nerve roots. The first option for treatment are epidural shots, which can reduce swelling enough in the effected area to fully eliminate the discomfort.

The Chiefs gave Poe one of those shortly after he first started experiencing back problems on June 2, when he left an OTA practice due to what the team called back spasms.

The shot worked, at least in the beginning; Poe missed a handful of practices but returned in time to participate in the team’s mandatory minicamp June 16-18.

Poe then received a second epidural injection before he headed home to Memphis for the players’ month-long break before camp, but he re-injured his back shortly thereafter, which led to the MRI that uncovered his herniated disk.

Chao said the Chiefs’ decision to try the epidural shots at the outset ― instead of surgery ― made sense.

“I think they’ve handled it pretty well,” Chao said. “Surgery is a significant procedure, and like I said, there are other guys with bulging/herniated disks that can play (through it).

“Once you do surgery, you’re buying three months of recovery and rehab, and no one wants to have spine surgery unless you have to because there are some potential long-term and post-football consequences, so you’d rather not do it if you can get away with it. If the epidurals would have worked, he would have been good for training camp and the first game of the season. What wouldn’t you want to try that?”

But with the surgery now in his rear-view mirror, both Chao and Anand agree that Poe can certainly return to 100 percent, at least in the short-term.

“The best analogy is to consider this as a puncture in a car tire with air leaking and the discectomy has patched it, but it does not make the car tire brand new,” Anand wrote.

“I don’t see any reason he can’t be back to 100 percent in the short term,” Chao said. “It’s just a matter of when.”

In the meantime, the Chiefs will be exploring different options in Poe’s absence. Reid said fourth-year pro Jaye Howard, who earned 10 starts last year, likely will get first crack at the job, though DeVito — a respected run-stuffer — has plenty of experience playing nose, as well.

But DeVito insists that no matter how long Poe will be in the sidelines, he won’t be far from their minds.

“With Poe, knowing how tough it is on the sideline, I need to make sure I am reaching out and talking to him,” DeVito said, “because I know how difficult it is.”

Kansas City Star Chiefs beat reporter Terez A. Paylor recaps Saturday's first full squad training camp practice in front of fans at Missouri Western State University.

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Thousands of fans waited in line to attend Chiefs training camp at Missouri Western State University on Saturday, Aug. 1. Practice opened to the public for the first time this weekend and will continue through the month of August.

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